scholarly journals Patient portals and broadband internet inequality

2017 ◽  
Vol 24 (5) ◽  
pp. 927-932 ◽  
Author(s):  
Adam T Perzynski ◽  
Mary Joan Roach ◽  
Sarah Shick ◽  
Bill Callahan ◽  
Douglas Gunzler ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Quality ◽  
Internet Access ◽  
Care Quality ◽  
Public Health Care ◽  
Patient Portal ◽  
Patient Portals ◽  
Broadband Internet ◽  
Care System

Abstract Background: Patient portals have shown potential for increasing health care quality and efficiency. Internet access and other factors influencing patient portal use could worsen health disparities. Methods: Observational study of adults with 1 or more visits to the outpatient clinics of an urban public health care system from 2012 to 2015. We used mixed effects logistic regression to evaluate the association between broadband internet access and (1) patient portal initiation (whether a patient logged in at least 1 time) and (2) messaging, controlling for demographic and neighborhood characteristics. Results: There were 243 248 adults with 1 or more visits during 2012–2015 and 70 835 (29.1%) initiated portal use. Portal initiation was 34.1% for whites, 23.4% for blacks, and 23.8% for Hispanics, and was lower for Medicaid (26.5%), Medicare (23.4%), and uninsured patients (17.4%) than commercially insured patients (39.3%). In multivariate analysis, both initiation of portal use (odds ratio [OR] = 1.24 per quintile, 95% confidence interval [CI], 1.23–1.24, P < .0001) and sending messages to providers (OR = 1.15, 95%CI, 1.09–1.14, P < .0001) were associated with neighborhood broadband internet access. Conclusions: The majority of adults with outpatient visits to a large urban health care system did not use the patient portal, and initiation of use was lower for racial and ethnic minorities, persons of lower socioeconomic status, and those without neighborhood broadband internet access. These results suggest the emergence of a digital divide in patient portal use. Given the scale of investment in patient portals and other internet-dependent health information technologies, efforts are urgently needed to address this growing inequality.

scholarly journals Patient Portal Functionalities and Uptake: Systematic Review Protocol

10.2196/14975 ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. e14975 ◽  
Author(s):  
Abrar Alturkistani ◽  
Geva Greenfield ◽  
Felix Greaves ◽  
Shirin Aliabadi ◽  
Rosemary H Jenkins ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care System ◽  
Health Care Quality ◽  
Care Quality ◽  
Risk Of Bias ◽  
Adult Patients ◽  
Patient Portal ◽  
Patient Portals ◽  
Quality Outcomes

Background Patient portals are digital health tools adopted by health care organizations. The portals are generally connected to the electronic health record of the health care organization and offer patients functionalities such as access to the medical record, ability to order repeat prescriptions, make appointments, or message the health care provider. Patient portals may be beneficial for both patients and the health care system. Patient portals can widely differ from one context to another due to the differences in the portal functionalities and capabilities and it is anticipated that outcomes associated with the functionalities also differ. Current systematic reviews report outcomes associated with patient portal uptake but do not explicitly specify the patient portal functionalities. Objective The aim of this systematic review is to synthesize the evidence on health and health care quality outcomes associated with patient portal use among adult (18 years or older) patients. The review research questions are as follows: What kind of health outcomes do tethered patient portals and patient portal functionalities contribute to in adult patients (18 years or older)? and What kind of health care quality outcomes, including health care utilization outcomes, do tethered patient portals and patient portal functionalities contribute to in adult patients (18 years or older)? Methods The systematic review will be conducted by searching the MEDLINE, EMBASE, and Scopus databases for relevant literature. The review inclusion criteria will be studies about adult patients (18 years or older), studies only about tethered patient portals, and studies with or without a comparator. We will report patient portal–associated health and health care quality outcomes based on the patient portal functionalities. All quantitative primary study types will be included. Risk of bias of included studies will be assessed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials and the National Heart, Lung, and Blood Institute’s quality assessment tools. Data will be synthesized using narrative synthesis and will be reported according to the patient portal functionalities, country, disease, and health care system model. Results Searches will be conducted in September 2019, and the review is anticipated to be completed by the end of June 2020. Conclusions This systematic review will provide an overview of health and health care quality outcomes associated with patient portal use among adult patients, providing detailed information about the functionalities of the portals and their associations with the outcomes. The review could potentially help patient portal evaluation studies by providing insights into outcomes associated with the different functionalities of patient portals. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=141131 International Registered Report Identifier (IRRID) PRR1-10.2196/14975

scholarly journals Patient Portal Functionalities and Uptake: Systematic Review Protocol (Preprint)

2019 ◽  
Author(s):  
Abrar Alturkistani ◽  
Geva Greenfield ◽  
Felix Greaves ◽  
Shirin Aliabadi ◽  
Rosemary H Jenkins ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care System ◽  
Health Care Quality ◽  
Care Quality ◽  
Risk Of Bias ◽  
Adult Patients ◽  
Patient Portal ◽  
Patient Portals ◽  
Quality Outcomes

BACKGROUND Patient portals are digital health tools adopted by health care organizations. The portals are generally connected to the electronic health record of the health care organization and offer patients functionalities such as access to the medical record, ability to order repeat prescriptions, make appointments, or message the health care provider. Patient portals may be beneficial for both patients and the health care system. Patient portals can widely differ from one context to another due to the differences in the portal functionalities and capabilities and it is anticipated that outcomes associated with the functionalities also differ. Current systematic reviews report outcomes associated with patient portal uptake but do not explicitly specify the patient portal functionalities. OBJECTIVE The aim of this systematic review is to synthesize the evidence on health and health care quality outcomes associated with patient portal use among adult (18 years or older) patients. The review research questions are as follows: What kind of health outcomes do tethered patient portals and patient portal functionalities contribute to in adult patients (18 years or older)? and What kind of health care quality outcomes, including health care utilization outcomes, do tethered patient portals and patient portal functionalities contribute to in adult patients (18 years or older)? METHODS The systematic review will be conducted by searching the MEDLINE, EMBASE, and Scopus databases for relevant literature. The review inclusion criteria will be studies about adult patients (18 years or older), studies only about tethered patient portals, and studies with or without a comparator. We will report patient portal–associated health and health care quality outcomes based on the patient portal functionalities. All quantitative primary study types will be included. Risk of bias of included studies will be assessed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials and the National Heart, Lung, and Blood Institute’s quality assessment tools. Data will be synthesized using narrative synthesis and will be reported according to the patient portal functionalities, country, disease, and health care system model. RESULTS Searches will be conducted in September 2019, and the review is anticipated to be completed by the end of June 2020. CONCLUSIONS This systematic review will provide an overview of health and health care quality outcomes associated with patient portal use among adult patients, providing detailed information about the functionalities of the portals and their associations with the outcomes. The review could potentially help patient portal evaluation studies by providing insights into outcomes associated with the different functionalities of patient portals. CLINICALTRIAL International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=141131 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/14975

Factors Associated With Americans' Ratings of Health Care Quality: What Do They Tell Us About the Raters and the Health Care System?

2010 ◽  
Vol 15 (sup3) ◽  
pp. 147-156 ◽  
Author(s):  
Wen-Ying Sylvia Chou ◽  
Lin Chun Wang ◽  
Lila J. Finney Rutten ◽  
Richard P. Moser ◽  
Bradford W. Hesse
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Quality ◽  
Care Quality ◽  
Factors Associated ◽  
Care System

The essence, content and characteristics of medical services’ quality

2021 ◽  
pp. 40-43
Author(s):  
Constantin Etco ◽  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care System ◽  
Health Care Quality ◽  
Services Quality ◽  
Care Quality ◽  
Medical Services ◽  
Total Quality ◽  
Care System

One of the priorities of the health care system in Moldova is the medical services’ quality improvement. Th is article presents various defi nitions for health care quality and the principles connected with quality improvement. An important part in this article is allocated to the structure and main principles of total quality management in the health care system. Th is part reveals the problems of the commissions that are studying the quality of medical services in healthcare establishments.

scholarly journals Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Abrar Alturkistani ◽  
Ambar Qavi ◽  
Philip Emeka Anyanwu ◽  
Geva Greenfield ◽  
Felix Greaves ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Health Care Quality ◽  
Care Quality ◽  
Risk Of Bias ◽  
Patient Portal ◽  
Patient Portals ◽  
Quality Outcomes ◽  
Patients With Diabetes ◽  
Reported Health

BACKGROUND Patient portal use could help improve the care and health outcomes of patients with diabetes owing to functionalities, such as appointment booking, electronic messaging (e-messaging), and repeat prescription ordering, which enable patient-centered care and improve patient self-management of the disease. OBJECTIVE This review aimed to summarize the evidence regarding patient portal use (portals that are connected to electronic health care records) or patient portal functionality use (eg, appointment booking and e-messaging) and their reported associations with health and health care quality outcomes among adult patients with diabetes. METHODS We searched the MEDLINE, Embase, and Scopus databases and reported the review methodology using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent reviewers screened titles and abstracts, and two reviewers assessed the full texts of relevant studies and performed data extraction and quality assessments of the included studies. We used the Cochrane Collaboration Risk of Bias Tool and the National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tool to assess the risk of bias of the included studies. Data were summarized through narrative synthesis. RESULTS Twelve studies were included in this review. Five studies reported overall patient portal use and its association with diabetes health and health care quality outcomes. Six studies reported e-messaging or email use–associated outcomes, and two studies reported prescription refill–associated outcomes. The reported health outcomes included the associations of patient portal use with blood pressure, low-density lipoprotein cholesterol, and BMI. Few studies reported health care utilization outcomes such as office visits, emergency department visits, and hospitalizations. A limited number of studies reported overall quality of care for patients with diabetes who used patient portals. CONCLUSIONS The included studies mostly reported improved glycemic control outcomes for patients with diabetes who used patient portals. However, limitations of studying the effects of patient portals exist, which do not guarantee whether the outcomes reported are completely the result of patient portal use or if confounding factors exist. Randomized controlled trials and mixed-methods studies could help understand the mechanisms involved in health outcome improvements and patient portal use among patients with diabetes. CLINICALTRIAL International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141131. INTERNATIONAL REGISTERED REPORT RR2-10.2196/14975

scholarly journals Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review

10.2196/18976 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e18976
Author(s):  
Abrar Alturkistani ◽  
Ambar Qavi ◽  
Philip Emeka Anyanwu ◽  
Geva Greenfield ◽  
Felix Greaves ◽  
...  
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Health Care Quality ◽  
Care Quality ◽  
Risk Of Bias ◽  
Patient Portal ◽  
Patient Portals ◽  
Quality Outcomes ◽  
Patients With Diabetes ◽  
Reported Health

Background Patient portal use could help improve the care and health outcomes of patients with diabetes owing to functionalities, such as appointment booking, electronic messaging (e-messaging), and repeat prescription ordering, which enable patient-centered care and improve patient self-management of the disease. Objective This review aimed to summarize the evidence regarding patient portal use (portals that are connected to electronic health care records) or patient portal functionality use (eg, appointment booking and e-messaging) and their reported associations with health and health care quality outcomes among adult patients with diabetes. Methods We searched the MEDLINE, Embase, and Scopus databases and reported the review methodology using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent reviewers screened titles and abstracts, and two reviewers assessed the full texts of relevant studies and performed data extraction and quality assessments of the included studies. We used the Cochrane Collaboration Risk of Bias Tool and the National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tool to assess the risk of bias of the included studies. Data were summarized through narrative synthesis. Results Twelve studies were included in this review. Five studies reported overall patient portal use and its association with diabetes health and health care quality outcomes. Six studies reported e-messaging or email use–associated outcomes, and two studies reported prescription refill–associated outcomes. The reported health outcomes included the associations of patient portal use with blood pressure, low-density lipoprotein cholesterol, and BMI. Few studies reported health care utilization outcomes such as office visits, emergency department visits, and hospitalizations. A limited number of studies reported overall quality of care for patients with diabetes who used patient portals. Conclusions The included studies mostly reported improved glycemic control outcomes for patients with diabetes who used patient portals. However, limitations of studying the effects of patient portals exist, which do not guarantee whether the outcomes reported are completely the result of patient portal use or if confounding factors exist. Randomized controlled trials and mixed-methods studies could help understand the mechanisms involved in health outcome improvements and patient portal use among patients with diabetes. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141131. International Registered Report Identifier (IRRID) RR2-10.2196/14975

scholarly journals Analysis of the Impact of Doctors’ and Health Care System Credibility on Patients’ Satisfaction with Health Care

2016 ◽  
Vol 22 (2) ◽  
pp. 201622
Author(s):  
Andriy Yavorskyy
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Services ◽  
Health Care Quality ◽  
Care Physician ◽  
Care Quality ◽  
Patients Satisfaction ◽  
Care Services ◽  
The Impact ◽  
Care System

Forming a patient-oriented health care system, patients’ participation in health care quality assessment has become the imperative of our time.The objective of the research was to analyze the impact of doctors’ and health care system credibility on satisfaction with health care.Materials and methods. Sociological survey of 530 patients was conducted. The patients completed their treatment in the surgical departments of inpatient facilities in Ivano-Frankivsk region. According to its results the patients were divided into two groups: satisfied (372 people) and not satisfied (158 people) with the level of health care services in the department and the hospital as a whole.Results of the research. Nearly 60% of the surveyed patients were determined not to trust their doctors and one third of respondents did not know their primary care physician. This significantly increased the chances of dissatisfaction with health care (OR= 4.11; 95% CI: 1.67–10.14, p<0.001 and OR=1.96; 95% CI: 1.33–2.90 respectively; p<0.001) and promoted inefficient use of the health care system resources as a result of unreasonable hospitalization (in 18.8% cases). Conclusions. Patients who do not trust doctors in general and do not know their general practitioner remain dissatisfied with inpatient care by 1.5-10 times more often.

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